摘要
目的探究血常规炎症指标与血清肿瘤标志物对肺癌的临床诊断效能。方法选取2019年10月至2022年9月丰城市人民医院收治的80例疑似肺癌患者作为研究对象,根据病理检查结果分为患者组(n=31)与对照组(n=49)。比较两组血常规炎症指标、血清肿瘤标志物水平,并分析上述指标对肺癌的诊断效能。结果患者组平均血小板体积(mean platelet volume,MPV)、血小板压积(plateletcrit,PCT)均大于对照组,血小板计数(platelet count,PLT)、中性粒细胞与淋巴细胞比值(neutrophil lymphocyte ratio,NLR)、粒细胞百分比(granulocyte percentage,Neu%)均高于对照组,乳酸脱氢酶(lactate dehydrogenase,LDH)水平低于对照组,差异有统计学意义(P<0.05);两组血小板分布宽度(platelet distribution width,PDW)、中性粒细胞绝对值(neutrophil absolute value,Neu#)、淋巴细胞绝对值(lymphocyte absolute value,Lym#)、红细胞体积分布宽度变异系数(red blood cell distribution width coefficient of variation,RDW-CV)、红细胞体积分布宽度标准差(erythrocyte volume distribution width standard deviation,RDW-SD)、淋巴细胞百分比(lymphocyte percentage,Lym%)比较差异无统计学意义。患者组癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白19的可溶性片段(cytokeratin 19 fragment antigen 21-1,CYFRA21-1)水平均高于对照组,差异有统计学意义(P<0.05);两组糖类抗原125(carbohydrate antigen 125,CA125)、糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、甲胎蛋白(alpha-fetoprotein,AFP)水平比较差异无统计学意义。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,CYFRA21-1、LDH、PCT、NLR诊断肺癌的曲线下面积(area under the curve,AUC)均>0.5,有一定诊断价值;其中CYFRA21-1最佳截断值为2.11μg/L,AUC为0.695,其诊断灵敏度、特异度分别为80.65%、91.84%;PLT、MPV、Neu%、CEA诊断肺癌的AUC均<0.5,无诊断价值;CYFRA21-1+LDH+PCT+NLR诊断肺癌的AUC最大,为0.857,灵敏度、特异度分别为90.32%、93.88%,具有较高诊断价值。结论CYFRA21-1、LDH、PCT、NLR联合检测对肺癌的诊断效能最高,具有临床应用价值。
Objective To explore the clinical diagnostic efficacy of blood routine inflammatory indexes and serum tumor markers for lung cancer.Methods 80 patients with suspected lung cancer admitted to Fengcheng People's Hospital from October 2019 to September 2022 were selected as the study subjects,and they were divided into the patient group(n=31)and the control group(n=49)according to pathological examination results.The blood routine inflammatory indexes and the levels of serum tumor markers were compared between the two groups,and the diagnostic efficacy of these indexes for lung cancer was analyzed.Results The mean platelet volume(MPV),plateletcrit(PCT)in the patient group were larger than those in the control group,platelet count(PLT),neutrophil lymphocyte ratio(NLR)and granulocyte percentage(Neu%)were higher than those in the control group,the levels of lactate dehydrogenase(LDH)were lower than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences of levels of platelet distribution width(PDW),neutrophil absolute value(Neu#),lymphocyte absolute value(Lym#),red blood cell distribution width coefficient of variation(RDW-CV),erythrocyte volume distribution width standard deviation(RDW-SD),lymphocyte percentage(Lym%)between the two groups.The levels of carcinoembryonic antigen(CEA)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)in the patient group were higher than those in the control group,and the differences were statistically significant(P<0.05);there were no significant differences of levels of carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9),alpha-fetoprotein(AFP)between the two groups.The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of diagnosis for lung cancer by CYFRA21-1,LDH,PCT and NLR were all>0.5,which had certain diagnostic value,and the best cutoff value of CYFRA21-1 was 2.11μg/L,AUC was 0.695,and diagnostic sensitivity and specificity were 80.65%and 91.84%,respectively;the AUC values of PLT,MPV,Neu%and CEA in the diagnosis of lung cancer were all<0.5,indicating no diagnostic value;CYFRA21-1+LDH+PCT+NLR had the largest AUC in the diagnosis of lung cancer(0.857),and the sensitivity and specificity were 90.32%and 93.88%,respectively,indicating high diagnostic value.Conclusion CYFRA21-1,LDH,PCT and NLR have the highest diagnostic efficiency in the diagnosis of lung cancer,and has clinical application value.
作者
黎斌
熊熙
刘友清
LI Bin;XIONG Xi;LIU Youqing(Department of Clinical Laboratory,Fengcheng People's Hospital,Fengcheng,Jiangxi,331100,China)
出处
《当代医学》
2025年第4期6-11,共6页
Contemporary Medicine
关键词
肺癌
血常规炎症指标
血清肿瘤标志物
诊断效能
Lung cancer
Blood routine inflammation indexes
Serum tumor markers
Diagnostic efficacy
